Clip device for endoscope and clip for endoscope for use therein

ABSTRACT

A clipping device improves defects that the clip can not be again opened once the clip is closed, and that it is necessary to execute the operation in a state in which the clip is not sufficiently opened. The invention provides a clip device for an endoscope constituted by a clipping means having a pair of arm portions which are allowed to be opened and closed, an operating means for holding the arm portions of the clipping means so as to open and close the arm portions, a fixing means for fixing the arm portions after closing the arm portions, and an arranging means for arranging the fixing means in an outer side of the arm portion.

TECHNICAL FIELD

The present invention relates to a clip device for an endoscope. Thepresent invention relates to a clip device used for a marking or thelike for clarifying an area to which a ligature or resection treatmentis applied in a bleeding portion in a biological tissue, for example,under an endoscopic treatment, and a clip used for the clip device.

PRIOR ART

A method of ligating the bleeding portion by introducing a clip in anendoscopic manner is much applied to the bleeding within a body cavity,however, such a clip is disclosed, for example, in JP-U-53-20957. Thisinvention is constituted by a clip in which a pair of clamping piecesare connected in a rear end and are crossed to each other in anintermediate portion and an inclined surface is formed in each of frontand rear outer surfaces of the crossing portion, and a fastening devicewhich is slid on the inclined surface of the clip so as to open andclose the clip, and an introduction device for sliding the fasteningdevice.

In this structure, the opening and closing of a pair of clamping piecesare open to the maximum so as to be in a state capable of gripping thetissue, at a time when the fastening device slides between the rear endof the clip and the crossing portion, and next, at a time of pressing apair of clamping pieces against the tissue to be clipped so as to slidethe fastening device to a front side of the crossing portion, a pair ofclamping pieces are closed so as to clip the tissue.

However, since this structure can only press out the fastening device tothe front side, there is a defect that the clip can not be opened oncethe clip is closed. Further, in order to make the clip to open to themaximum, it is necessary to stop the fastening device just before thecrossing portion of the clip, however, it is hard to adjust a positionthe fastening, device due to a sliding resistance of the fasteningdevice, so that there is a case that the fastening device passes a pointwhere the clip is opened to the maximum, and it is necessary to executethe operation under a state in which the clip is not sufficientlyopened.

Further, the clip device moves into the fastening device to which thecrossing portion of the clip is fixed, by catching the rear end of theclip by a hook having a release cord and pulling the release cord, and apair of clamping pieces are opened to the maximum so as to be in a statecapable of gripping the tissue. Next, the clip further moves within thefastening device by pressing a pair of clamping pieces against thetissue to be clipped and again pulling the release cord, and a pair ofclamping pieces are closed so as to clip the tissue.

However, since the clip device executes the opening and closingoperation on the basis of a series of operations of pulling the releasecord, the clip can not be returned to the state before entering into thecrossing portion in the case that the crossing portion of the clip onceenters into the fastening device. In other words, the clip device has adefect that the once closed clip can not be again opened. Further, inorder to open the clip to the maximum, it is necessary to stop thefastening device just before the crossing portion of the clip, however,it is impossible to adjust the position due to the sliding resistance ofthe fastening device, and the fastening device passes the point wherethe clip is opened to the maximum, so that there is a case that it isnecessary to execute the operation in a state in which the clip is notsufficiently opened.

Further, in JP-B2-63-6016, there is disclosed a method of mounting theclip to the clip device. Since the clip is fixed in a state in which abase end portion of the clip is engaged with a hook provided in the clipdevice, it is necessary to execute a complicated operation of applyingthe clip to the hook while gripping the clip by one hand at a time ofmounting, so that an operator who is not accustomed to this operationrequires a lot of time for this operation.

DISCLOSURE OF THE INVENTION

An object of the present invention is to provide a clipping device whichimproves defects that the clip can not be again opened once the clip isclosed, and that it is necessary to execute the operation in a state inwhich the clip is not sufficiently opened.

Further, another object of the present invention is to provide a methodof easily mounting the clip so as to shorten a mounting time.

In other words, in accordance with the present invention, there isprovided a clip device for an endoscope comprising:

a clip having a pair of arm portions which are allowed to be opened andclosed;

an operating means for holding the arm portions of the clipping means soas to open and close the arm portions;

a fixing means for fixing the arm portions in a closed state afterclosing the arm portions; and

an arranging means for arranging the fixing means in an outer side ofthe arm portion.

In the clip device for the endoscope mentioned above, it is preferablethat the arm portions of the clip are connected in a base portion in astate in which a width thereof is continuously reduced around a part oran entire of the arm portions.

In the clip device for the endoscope mentioned above, it is preferablethat the fixing means and the clip are previously arranged in a smallhole provided on a plate, and are thereafter loaded to the device.

Further, in accordance with the present invention, there is provided aclip for an endoscope, the clip being used for a clipping device for theendoscope, wherein a mechanism for fixing to the clipping device for theendoscope is provided in arm portions of the clip.

Further, in accordance with the present invention, there is provided aclipping device for an endoscope having the clip for the endoscopementioned above.

Further, in accordance with the present invention, there is provided aclipping device for an endoscope comprising:

-   -   a hollow member having at least a pair of operating means in a        leading end, the operating means being constituted by an elastic        operating arm;    -   an outer member covering the hollow member;    -   a control member connected to the outer member;    -   a clip; and    -   a fixing means for fixing the clip after clipping,    -   wherein the clip has a means for fixing to the operating arm,        and the operating means are opened and closed by moving the        control member connected to the outer member in an axial        direction.

Further, in accordance with the present invention, there is provided aclipping device for an endoscope comprising:

-   -   a hollow member having at least a pair of operating means in a        leading end, the operating means being constituted by an elastic        operating arm;    -   an outer member covering the hollow member;    -   a control member connected to the outer member;    -   a clip; and    -   a fixing means for fixing the clip after clipping,    -   wherein the operating arms have a means for fixing to the clip,        and the operating means are opened and closed by moving the        control member connected to the outer member in an axial        direction.

BRIEF DESCRIPTION OF THE DRAWINGS

FIGS. 1(a) and 1(b) are views showing an outline of a clipping devicecorresponding to an embodiment in accordance with the present invention,in which FIG. 1(a) is a general view and FIG. 1(b) is an enlarged viewof a connection portion between a clip and an operating means;

FIG. 2 is a view for describing the clip in accordance with the presentinvention;

FIGS. 3(a) and 3(b) are views for describing another embodiment of theoperating means of the clipping device in accordance with the presentinvention, in which FIG. 3(a) is a view showing a state in which theclip is closed, and FIG. 3(b) is a view showing a state in which theclip is opened;

FIG. 4 is a view showing a state in which the clip and the fixing meansare set to a plate;

FIG. 5 is a view showing a cross section of the plate at a time when theclip and the fixing means are set to the plate;

FIGS. 6(a) to 6(d) are views for describing a method of mounting a clipto a clip device for an endoscope;

FIG. 7 is a view showing a state in which the clip is loaded;

FIG. 8 is a view for describing a method for loading the fixing meansand the clip by one operation;

FIGS. 9(a) to 9(d) are views for describing a method of using theclipping device in accordance with the present invention;

FIG. 10 is a view showing a clip corresponding to a first embodiment inaccordance with the present invention;

FIG. 11 is a view showing a clip corresponding to a second embodiment inaccordance with the present invention;

FIG. 12 is a view showing a clip corresponding to a third embodiment inaccordance with the present invention; and

FIGS. 13(a) and 13(b) are cross sectional views showing a state in whichthe clip for the endoscope in accordance with the present invention ismounted to the clipping device, in which FIG. 13(a) is a view showing astate in which the clip for the endoscope is closed, and FIG. 13(b) is aview showing a state in which the clip for the endoscope is opened.

BEST MODE FOR CARRYING OUT THE INVENTION

A description will be in detail given below of the present invention byusing embodiments. FIGS. 1(a) and 1(b) are views showing a clippingdevice for an endoscope corresponding to an embodiment in accordancewith the present invention, in which FIG. 1(a) is a general view andFIG. 1(b) is an enlarged view of a connection portion between a clip andan operating means. FIG. 2 is a view showing an embodiment of the clip,and FIGS. 3(a) and 3(b) are views showing another embodiment of theoperating means in accordance with the present invention, in which FIG.3(a) shows a state in which the clip is closed, and FIG. 3(b) shows astate in which the clip is opened. FIG. 4 is a view showing a state inwhich the clip and the fixing means are set to a plate. FIG. 5 is across sectional view of the plate at a time when the clip and the fixingmeans are set to the plate, and FIGS. 6(a) to 6(d) are views fordescribing a method of mounting a clip to a clip device for an endoscopein accordance with the present invention. FIG. 7 is a view showing astate in which the clip is loaded, FIG. 8 is a view for describing amethod for loading the fixing means and the clip by one operation, FIGS.9(a) to 9(e) are views for describing a method of using the clippingdevice for the endoscope in accordance with the present invention.

The clipping device in FIG. 1 is constituted by a clip 1, an operatingmeans 2, a fixing means 3 and a pushing tube 11 for sliding the fixingmeans 3 to a front side.

The clip 1 is formed, for example, by a sheet metal as shown in FIG. 2,and has a pair of arm portions 5, and the arm portions 5 are connectedin a rear end connection portion 6. The connection portion 6 ispreferably structured as a hinge structure, however, may be structuredby simply bonding the arm portions to each other by means of a weldingor the like, or folding one sheet metal plate in an illustrated shape. Aleading end of the arm portion 5 is folded inside at a fixed angle so asto eat into a tissue.

Further, in order to fit the arm portions 5 to a hook 10 provided in anoperating arm 7 mentioned below, the structure is made such that a widthof the connection portion 6 is smaller than a width of the arm portion5, and the width is continuously reduced from the arm portion 5 towardthe connection portion 6 all around a part or an entire constituting thearm portion 5.

The operating means 2 is constituted by a combination of a pair ofoperating arms 7 and a sheath 8 as shown in FIG. 1. A wire 15 forexecuting an opening and closing operation of the operating arms 7 isconnected to a rear end of the operating arms 7, and executes theopening and closing operation of the operating arms 7 in a remotemanner.

The operating arms 7 can employ a structure formed by bonding rear endsof two C-shaped leaf springs. This structure is always in an open state,however, the operating arms 7 are elastically deformed so as to be in aclosed state in the case that the operating arms 7 are received in aninner cavity of the sheath 8, and the state in which the operating arms7 are open is restored on the basis of a spring stress of the operatingarms 7 in the case that the operating arms 7 are slid so as to come outfrom the sheath 8.

The means for opening and closing the operating arm 7 is not limited tothis, and may employ, for example, another embodiment as shown in FIG.3. In this embodiment, a pair of operating arms 8 connected in the rearends are arranged within the sheath 8 with holding a rod 12 provided ina diametrical direction of the inner cavity of the sheath 8therebetween. When sliding the operating arms 7 to a front side so as tomove the connection portions of the operating arms 7 close to the rod12, the operating arms 7 are opened (a state shown in FIG. 3(b)), andwhen they are moved backward, the operating arms 7 are closed (a stateshown in FIG. 3(a)). Two embodiments are exemplified, however, thepresent invention is not limited to them in the embodiment of theoperating means 2.

The hook 10 is provided in a leading end of the operating arm 7, and hasa structure that the hook 10 can fix the arm portions 5 in a detachablestate by inserting the arm portions 5 of the clip 1 to an inner portionof the hook 10. Further, the connection portion 6 of the clip 1 isinserted to a base portion 9 of the operating arm, and is fixed in adetachable state. In other words, the clip 1 is fixed to the operatingmeans 2 at three points comprising a pair of operating arms 7 of theoperating means 2 and the base portion 9, and opens and closes the armportion 5 of the clip 1 by taking the operating means 2 in and out fromthe sheath 8.

The fixing means 3 is arranged on an outer periphery of the leading endportion of the sheath 8, and executes an extrusion by sliding a pushingtube 11 provided in an outer side of the sheath 8 to a front side. Theclip 1 is fixed in a closed state by gripping the tissue by means of thearm portions 5 of the clip 1 and thereafter sliding the fixing means 3to a front side so as to arrange in the arm portion 5 of the clip 1.

Next, a description will be given of a loading of the fixing means andthe clip.

As shown in FIGS. 4 and 5, the clip 1 and the fixing means 3 arepreviously set to a small hole 22 provided in a plate 21. A step isprovided in the small hole, and the clip 1 and the fixing means 3 areheld in a state of striking against the step. In the case of carryingthe plate, an upper surface of the plate 21 is covered by the platecover 23, thereby preventing the clip 1 and the fixing means 3 fromfalling away from the plate 21.

In this case, a description will be briefly given of a mounting methodof the clip 1 in accordance with the present invention by using FIGS.6(a) to 6(d), and an effect of the present invention is more clarified.

The sheath 8 is compressed to the fixing means 3 which is previously setto the plate 21 in a state of closing the operating means 2 (FIG. 6(a)),and the fixing means 3 is loaded to the outer periphery of the sheath 8(FIG. 6(b)). Next, the sheath 8 is compressed to the clip 1 which ispreviously set to the plate 21, and the arm portions 5 of the clip 1 areslid into the hooks 10 of the operating arms 7 which are received in thesheath 8 (FIG. 6(c)), whereby the loading is completed (FIG. 6(d)).

FIG. 7 shows a state of the clip 1, the operating arms 7 and the hooks10 which are completed loading. Although an illustration is omittedhere, the fixing means is loaded in the outer periphery of the sheath 8.Since a width of the connection portion 6 of the clip 1 is smaller thana width of the arm portion 5, and the structure is made such that thewidth is continuously reduced from the arm portions 5 toward theconnection portion 6 all around a part or an entire of the structure ofthe arm portions 5, it is possible to insert the arm portions 5 to innersides of the hooks 10 only from a direction of the connection portion 6of the clip 1 (an arrow in the drawing) so as to fit and fix).

As mentioned above, in accordance with the present invention, it ispossible to load the fixing means 3 and the clip 1 only by compressingthe sheath 8 to the plate 21. Further, it is not necessary toindependently execute the loading of the fixing means 3 and the clip 1,a plurality of steps can be provided in the small hole 22 of the plate21, and the loading can be completed by one compressing operation.

In this case, a description will be given of a using procedure of theclip device for the endoscope in accordance with the present inventionwith reference to FIGS. 9(a) to 9(e), and the effect of the presentinvention is more clarified.

After mounting the fixing means 3 on the sheath 8 in a state in whichthe operating means 2 is closed, the clip 1 is mounted to the operatingmeans 2 (FIG. 9(a)). At this time, the arm portions 5 of the clip 1 areinserted to the inner sides of the hooks 10 provided in the leading endsof the operating arms 7, and the connection portion 6 is inserted to thebase portion 9 of the operating means 2.

In the case that the portion to be clipped is defined under theendoscopic operation, the device in accordance with the presentinvention is introduced. Since the arm portions 5 of the clip 1 areopened by sliding the operating arms 7 to the front side and opening theoperating arms 7, the arm portions are pressed against the tissue to betreated in this state. Next, the arm portions 5 are closed by moving theoperating arms 7 backward, thereby ligating the tissue (FIGS. 9(b) and9(c)). At this time, if an effect of the ligature is insufficient, thearm portions 5 are opened by again sliding the operating arms 7 to thefront side, whereby it is possible to execute the clipping operationagain and again.

In the case that an acceptable clipping is achieved, the arm portions 5are fastened by sliding the pushing tube 11 to the front side andcoating the arm portions 5 with the fixing means 3 (FIG. 9(d)).Thereafter, when the wire 15 and the pushing tube 11 are pulled outtogether, the clip 1 is released from the operating means 2 and theclipping operation is completed (FIG. 9(e)).

The clip 1 is maintained for some days to one week in a state ofligating the tissue. Thereafter, the tissue becomes necrotic, and theclipping means 1 naturally falls away together with the necroticportion, and is discharged out of the body.

Next, a description will be given of the clip which is used in the clipdevice for the endoscope in accordance with the present invention byusing the embodiment. FIGS. 10, 11 and 12 are views showing a clip inaccordance with an embodiment of the present invention. FIG. 13 is across sectional view showing a state in which the clip in accordancewith the present invention is mounted to the clipping device for theendoscope.

In FIG. 10, a ring-shaped first fixing portion 37 is provided in an armportion 38 of a clip 31, and the clip 31 can be fixed and opened andclosed by passing an operating arm 35 of the clipping device to thefirst fixing portion 37. A width of the operating arm 35 becomes wide inthe middle thereof, and the operating arm 35 is structured such as notto move forward to the first fixing portion 37 at a fixed distance ormore.

In FIG. 11, an open first fixing portion 37 is provided in the armportion 38 of the clip 31, a second fixing portion 39 having aconvex-shaped leading end in the operating arm 35 is inserted and fixedto the first fixing portion 37, and the arm 35 is structured such as tobe fixed and opened and closed by moving the second fixing portion 39 toa narrower side.

In FIG. 12, the width of the arm portion 38 of the clip 31 is changed ina bent portion, and the first fixing portion 37 is provided by utilizinga width difference. The operating arm 35 is structured such that thesecond fixing portion 39 is provided and is opened and closed so as togrip the first fixing portion 37.

The first fixing portion 37 and the second fixing portion 39 describedin FIGS. 10 to 12 can be fixed and opened and closed even in the casethat the clip 31 and the operating arm 35 are inversely mounted.

Further, the clipping device in accordance with the present invention isconstituted, as shown in FIG. 13, by a cylindrical tube 33 correspondingto a hollow member having an operating means constituted by a pair ofelastic operating arms 35 in a leading end, an operating arm opening andclosing tube 32 corresponding to an outer member for covering thecylindrical tube 33 and opening and closing the operating arm 35, acontrol member 34 connected to the outer member 32, and the clip 31having an arm portion capable of executing an opening and closingoperation.

A description will be given of a principle for executing an opening andclosing motion of the present device. The operating arms 35 for fixingand opening and closing the clip 31 are made of a material generating anelastic deformation, and is mounted in a state in which the arms arealways open as shown in FIG. 13(b). The arm holding tube 32 is used formaking the operating arms 35 in a closed state.

In order to open and close the operating arms 35, it is necessary tomove the operating arm opening and closing tube 32 in an axialdirection. This motion can be achieved by bonding the control member 34at a bonding point 36 and moving the control member 34 in the axialdirection. The control member 34 passes through an inner portion of thecylindrical tube 33, however, may pass through an outer portion of thecylindrical tube 33. At this time, any shape of the control member 34can be employed as far as the control member 34 can control theoperating arm opening and closing tube 32.

It is possible to carry out the operation of opening and closing theclip 31 without changing the position of the clip 31, by employing theoperating principle described above. Further, on the contrary, it ispossible to open and close the clip 31 while moving the clip 31 byfixing the control member 34 and moving the cylindrical tube 33.

Next, a description will be given of the first fixing portion 37 to thearms. In accordance with an example of method of fixing the clip 31 tothe operating arms 35, as shown in FIG. 10, the clip can be fixed byapplying the ring-shaped first fixing portion 37 to the clip 21 andpassing the operating arms 35 therethrough. In FIG. 10, the ring shapeis provided in the clip 31 side, however, may be provided in theoperating arm 35 side conversely.

Further, in connection with the first fixing portion 37 to the arms, thefixing means 37 is formed in the ring shape in the drawing, however, itis possible to employ any means which can fix the clip 31 to theoperating arms 35, such as a fitting utilizing a concavity andconvexity, an adhesive agent and the like.

A description will be given of a fixing means of the clip after beingclipped.

There can be listed up a method of utilizing a spring elasticity of theclip 31 as one example. This structure is made such that the clip 31 ismanufactured in a closed state, the clip 31 is opened by using a forcegenerated by the opening of the operating arms 35 at a time of clipping,and the clip 31 is closed by utilizing a restoring force of the clip 31after finishing the clipping.

Further, it is possible to employ a method of independently arrangingthe ring for fixing, for fixing the clip 31. There can be listed up amethod of fixing the fixing ring to the clip 31 by arranging the ring inthe leading end of the operating arm opening and closing tube 32 andprotruding the operating arm opening and closing tube 32 from theoperating arm 35, a method of arranging the fixing ring in the outerperiphery of the operating arm opening and closing tube 32 and extrudingthe fixing ring by the pushing tube covering the operating arm openingand closing tube 32 and the cylindrical tube 33, and the like.

A description will be given below of an operating procedure of theclipping device using the clip in accordance with the present invention.

The clip 31 is mounted to the first fixing portion 37 in a state inwhich the opening arm 35 is closed as shown in FIG. 13(a). Next, thepresent device is introduced after the portion to be clipped is definedunder the endoscopic operation. Since the operating arm opening andclosing tube 32 is moved to the rear side by moving the control member34 to the rear side, and the operating arm 35 and the endoscope clip 31are opened as shown in FIG. 13(b), the operating arm 35 and theendoscope clip 31 are compressed to the tissue to be treated. Next, thecontrol member 34 is moved forward, the operating arm 35 is closed, andthe tissue is ligated. At this time, if the efficient of the ligature isinsufficient, the operating arm 35 is opened by moving the controlmember 34 to the rear side. Accordingly, it is possible to carry out theclipping operation again and again.

In the case that the acceptable clipping is achieved, the clip 31 isfastened by means of the operating arm opening and closing tube 32, byfurther moving the control member 34 to the front side, and theendoscope clip 31 is fixed by the fixing means (not shown) of the clip.Since the clip 31 is fixed to the tissue, the operating arm 32 comes offfrom the first fixing portion 37 by moving an entire of the clippingdevice to the rear side.

The clip 31 is maintained for some days to one week in a state ofligating the tissue. Thereafter, the tissue becomes necrotic, and theclipping means 1 naturally falls away together with the necroticportion, and is discharged out of the body.

Industrial Applicability

As is apparent from the above description, since the clipping device forthe endoscope in accordance with the present invention can freely openand close the clip, it is possible to carry out the clipping operationagain and again and it is possible to easily mount the clip.Accordingly, the clip device for the endoscope in accordance with thepresent invention is extremely effective for the clip device used inmarking for clarifying the area for carrying out the treatment such asthe ligature, the resecting and the like of the bleeding portion in thebiological tissue under the endoscopic operation.

1. (Canceled)
 2. A clip device for an endoscope comprising: a hollowmember having a pair of operating means in a leading end, said operatingmeans being constituted by a pair of elastic operating arms; an outermember covering said hollow member and provided for opening and closingthe operating means; a control member connected to said outer member; aclip having arm portions capable of being opened and closed; and afixing means for fixing the clip after clipping, wherein the operatingmeans is opened and closed by moving the control member connected to theouter member in an axial direction.
 3. A clip device for an endoscope asclaimed in claim 2, wherein the arm portions of the clip have a meansfor fixing to the operating arms.
 4. A clip device for an endoscope asclaimed in claim 2, wherein the operating arms have a means for fixingto the arm portions of the clip.
 5. A clip device for an endoscope asclaimed in claim 2, wherein the arm portions of the clip means areconnected in a base portion in a state in which a width thereof iscontinuously reduced around a part or an entire of the arm portions. 6.A clip device for an endoscope as claimed in claim 2, wherein the armportion of the clip is always closed in the clip single body state, onthe basis of an elasticity of the clip material or another elastic bodymounted to the arm portions.
 7. A clip device for an endoscope asclaimed in claim 2, wherein the fixing means and the clip are previouslyarranged in a small hole provided on a plate, and are thereafter loadedto the device.